Spoken Vocabulary Outcomes of Toddlers With Developmental Delay After Parent-Implemented Augmented Language Intervention

Abstract

Purpose Early intervention using augmentative and alternative communication (AAC) supports both receptive and expressive language skills. However, many parents and clinicians still worry that augmented language intervention might delay or impair speech development. This study aimed to (a) characterize and analyze the speech sound development of toddlers with developmental delay who participated in a parent-implemented language intervention; (b) examine the accuracy of speech sounds among toddlers who participated in an augmented language intervention using speech-generating devices and toddlers who participated in a traditional, spoken language intervention; and (c) examine the relationship between baseline factors (i.e., receptive and expressive language skills, vocal imitation, and number of unintelligible utterances) and the number of spoken target vocabulary words after intervention. Method This study used extant data from two randomized control trials of parent-implemented language interventions using AAC or spoken language. Out of 109 children who completed the intervention, 45 children produced spoken target vocabulary words at the end of the intervention. We identified and phonetically transcribed spoken target vocabulary words for each child and then classified them based on Shriberg and Kwiatkowski's (1982) developmental sound classes. Results Children's speech sound accuracy was not significantly different across intervention groups. Overall, children who produced more words had more speech sound errors and higher baseline language scores. Intervention group and baseline receptive and expressive language skills significantly predicted the number of spoken target vocabulary words produced at the end of intervention. Conclusions Participation in AAC intervention resulted in significantly more spoken target vocabulary words and no statistically significant differences in speech sound errors when compared to children who received spoken language intervention without AAC. Results support using AAC interventions for very young children without the fear that it will delay speech or spoken language development. Supplemental Material https://doi.org/10.23641/asha.14265365

Augmentative and Alternative Communication Intervention Targets for School-Aged Participants with ASD and ID: A Single-case Systematic Review and Meta-analysis

“…Parents are sometimes hesitant to choose an AAC application due to fears that their children will be less motivated to develop spoken language (Donato et al, 2018;Moorcroft et al, 2019). Numerous authors have reported these fears to be unfounded (Donato et al, 2018;Johnston et.al., 2012;Walters et al, 2021). However, it is important to know whether and how prior experience with AAC has an impact on social-communication outcomes for this population to better inform future treatment decisions.…”

Commentary and Clinical Implications of “State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy”

“…AAC is considered a yellow light intervention with a small body of very low-quality evidence supporting its use in children with cerebral palsy to improve their communication, supplement verbal speech and increase peer interactions. However, a more robust evidence exists outside the cerebral palsy population [46], supporting targeting outcomes including (i) development of functional communication skills [47], (ii) improved expressive and receptive language and social skills [48], (iii) verbal speech development [49][50][51], and (iv) quality of life and independence [52].…”

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“…Parents are sometimes hesitant to choose an AAC application due to fears that their children will be less motivated to develop spoken language (Donato et al, 2018;Moorcroft et al, 2019). Numerous authors have reported these fears to be unfounded (Donato et al, 2018;Johnston et al, 2012;Walters et al, 2021). However, it is important to know whether and how prior experience with AAC has an impact on social-communication outcomes for this population to better inform future treatment decisions.…”